Here we outline how to assess calf muscle flexibility as well as various calf muscle stretching exercises which are used to increase calf muscle flexibility and recover from calf muscle and achilles tendon injuries.
The calf muscles consist of the larger gastrocnemius muscle and the lower soleus muscle. In order to properly stretch the calf muscles exercises must be done with the leg straight as well as with the knee bent.
Assessing calf muscle flexibility
There will be a point where the resistance noticeably increases as the muscle begins to stretch. It is likely the therapist will feel this before the patient feels a stretch on the calf muscles. As the foot moves further up the patient will begin to feel a stretch themselves. A general guide is that the foot should reach 90 degrees or point vertically up before the therapist feels any resistance from the muscle starting to stretch.
Gastrocnemius muscle stretches
The gastrocnemius muscle is the larger of the two calf muscles at the back of the lower leg. It originates above the knee at the back of the leg and inserts via the achilles tendon into the back of the heel. Because the muscle crosses both the knee joint and the ankle joint the leg must be straight in order to properly stretch this muscle.
There are a number of ways of stretching the calf muscles. One of the most common is against a wall. The athlete places the leg to be stretched behind them and leans into the wall keeping the heel of the back leg down pressing it into the floor. A stretch should be felt at the back of the lower leg. If a stretch is not felt then the foot can be moved further back until the muscle is stretched. This stretch can also be increased by placing something such as a weights disc under the forefoot. The stretch can be held for 20 to 30 seconds.
Another method is stretching on a step. The athlete stands on a step and allows the heel to drop down as far as it will go using gravity and body weight to achieve the stretch which should again be felt at the back of the lower leg. This will most likely get a much deeper stretch than stretching against a wall, however if you have suffered an injury such as an Achilles rupture then care should be taken when stretching the calf muscles. Again, stretches can be held for 20 to 30 seconds.
Active calf stretch is the most simple and basic of calf muscle stretching exercises. In a seated position the athlete simply holds the leg out straight and pulls the toes and foot upwards, holding the position. A light stretch should be felt in the calf muscles. This is probably more beneficial in the earlier stages of rehabilitation from a calf muscle injury or achilles tendon injury. A light stretch only will be achieved, however this does work with the bodies nervous system in that using the muscles which have the opposite action to the calf muscles encourages the calf muscles to relax.This stretch can be held for up to 10 seconds.
Soleus muscle stretches
The soleus muscle is the smaller of the two calf muscles and originates from the upper part of the tibia or shin bone and fibula below the knee and inserts via the achilles tendon into the back of the heel. Therefore it is important to stretch the soleus muscle with the knee bent. This relaxes the large gastrocnemius muscle taking it out of the stretch.
There are a number of ways to achieve a stretch of the soleus muscle. One way is against a wall with the leg to be stretched out behind and the knee bent. Lean into the wall increasing the bend in the knee until a stretch is felt low down at the back of the lower leg and achilles tendon area. The stretch can be increased by bending the knee more or moving the leg further back. Again, placing something underneath the forefoot to raise it up an inch will also increase the stretch.
Another more advanced method of stretching the soleus muscle against a wall is to place the leg to be stretched in front with the forefoot against the wall and heel on the floor. Gentle push the knee towards the wall until a stretch is felt low down at the back of the lower leg.
The soleus muscle can also be stretched actively in the same way as the gastrocnemius muscle by pulling the foot and toes up and holding but with the knee bent.
Muscle energy technique stretching
This type of stretching involves contracting the muscle against resistance supplied by a partner or therapist alternating with stretching. It is thought to be particularly useful for lengthening tight or shortened muscles.
To stretch the calf muscles using MET the athlete is positioned seated down with the feet protruding over the edge of a table. The therapist or partner then applies a gentle stretch passively using their hands. The athlete then contracts the calf muscles to push down with 25% of the maximum force they could apply against the therapists resistance. The therapist ensures the foot does not actually move and only a static muscle contraction is applied and held for 10 seconds.
After 10 seconds the athlete relaxes and allows the stretch to be increased by the therapist for a few seconds until the new limit of stretch is reached. They once again contract the calf muscles at 25% effort and hold for 10 seconds before relaxing to increase the stretch further. This is continued until no further gains are achieved.
Because the calf muscles are particularly strong it may be easier for a therapist to hold the resistance with the athlete in a a prone position lying down with the feet over the edge of the table and foot against the thigh of the therapist. They can then use the strength of the leg to resist the calf muscle contractions using the knee to increase the stretch.